Clinical comparison of preventive and therapeutic effects of lamivudine and entecavir on HBV reactivation among patients with non- Hodgkin lymphoma

Objective To investigate the preventive and therapeutic effects of lamivudine and entecavir on hepatitis B virus (HBV) reactivation among non- Hodgkin lymphoma (NHL) patients with chronic HBV infection during chemotherapy.Methods From January 2008 to April 2013, a total of 94 NHL patients with HBV infection were recruited from our hospital and divided into lamivudine treatment group and entecavir treatment group.The lamivudine treatment group received chemotherapy with lamivudine (100 mg / d) , and the entecavir treatment group received chemotherapy with entecavir (0.5 mg / d) .The rates of virological breakthrough, primary non- response, and virological breakthrough- related hepatitis flare were compared between groups.The t- test was used for comparison between two groups of independent samples;one- way analysis of variance was conducted for comparison between three groups of independent samples;the chi- square test was used to conduct intergroup comparison.Results For the patients with HBV DNA levels lower than 103copies / ml before anti- HBV treatment, no significant difference was found in the rate of virological breakthrough or rate of hepatitis flare between lamivudine treatment group and entecavir treatment group (χ2= 1.03, P > 0.05) .For the patients with HBV DNA levels higher than 103copies / ml before anti-HBV treatment, the lamivudine treatment group had a virological breakthrough rate of 37.5%, a primary non- response rate of 9.4%, a hepatitis flare rate of 28.1%, and a liver failure rate of 3.1%, and the aforementioned rates for entecavir treatment group were 3.1%, 0, 0, and 0, respectively;there were significant differences in the rates of virological breakthrough and hepatitis flare between the two groups (χ2= 11.68, P < 0.05;χ2= 10.47, P < 0.05) .Conclusion Among NHL patients with HBV infection whose HBV DNA levels are lower than 103copies / ml, the preventive and therapeutic effects of lamivudine and entecavir on HBV reactivation are similar;among NHL patients with HBV infection whose HBV DNA levels are higher than 103copies / ml, those treated with entecavir have lower rates of virological breakthrough and hepatitis flare than those treated with lamivudine, which helps patients have a smoother progress of chemotherapy.